1. Videostroboscopy Workshop Jeffrey Lehman, MD Updated 2/21/2017
April 21, 2017
Chicago
Videostroboscopy Workshop
Jeffrey Lehman, MD
Updated 2/21/2017

2. LARYNGEAL STROBOSCOPY
Attribution and thanks to Author RALPH IANNUZZI, MD

3. Learning Objectives
Recognize the usage and care of videostroboscopy equipment.
Discuss indications for videostroboscopy examination of the adult.
Identify normal anatomy, normal variants and abnormal findings visible via videostroboscopy
Practice performing and recording a videostroboscopy exam on a simulated adult patient.

4. Intro to Stroboscopy Identify System Components
Understanding How a Strobe Works
System Operations
Introduction to the Clinical Exam

5. Identifying System Components
Monitor
Strobe Light Source ( foot pedals)
Camera and Lens
Endoscope (flexible or Rigid)
Microphones
Recording System (computer, DVD or VCR)
Printer
Uninterrupted Power Supply (UPS)
OPTIONAL ITEMS
EPK Processor
Electroglottograph
Cart

6. Understanding How A Strobe Works
Strobe box has two types of light, a flashing Xenon and a constant Halogen for constant viewing.
A microphone is used to detect the Fundamental Frequency of the vocal folds.
The flash is synchronized (video rate 30 times a second) or Pitch rate.

7. Understanding How A Strobe Works
The flashing Strobe light creates an illusion that the cords are moving in slow motion, but it is actually a composite image, sampled from a variety of glottal cycles.

10. Muscle Vibratory layer
Any change that affects this layer – stiffness of vocal fold layers, weakness or failure of closure, imbalance between R and L vocal folds from a lesion on one vocal fold – causes voice problems.

11. Diagnostic Value of Stroboscopic Examination in Hoarse Patients
“Videostroboscopy contributed significant diagnostic information in 27.2% of the cases” (versus non-stroboscopic means).
“It was instrumental in changing the diagnosis in 10% of the cases.”
Case no. 4: original diagnosis was “recurrent laryngeal cancer”; changed to “excessive mucous”
Conclusion: “Stroboscopy should be performed in selected patients suspected of vocal fold pathology. It is especially useful in serial examinations to help assess treatment progress.”
“Diagnostic Value of Stroboscopic Examination in Hoarse Patients”, Woo, Peak, et.al.; 1991: Journal of Voice, Vol. 5; No. 3

12. More Pronounced Results In Study Done By Sataloff, et.al
Diagnoses were noted before and after employing use of videostroboscopy in 377 patients
Results:
29% of original diagnoses had additional diagnosis added
18% of original diagnoses were incorrect
47% of original diagnoses were modified
Sataloff, et.al.; “Strobovideolaryngoscopy: Results and Clinical Value; Annals of Oto, Rhino, Laryngo, September 1991

13. Database

14. Assessment form and selections based on Bless and Hirano Template.
Data and still images from database are imported into a Microsoft Word template customized to your institution.
Later changes reflect emphasis on report writing, network integration, and database features.

15. REVIEW OF STROBES RECORDINGS
-See CD
REVIEW OF STROBES RECORDINGS

16. Videostroboscopy Workshop: Evaluation
Score cards will be used for admission to workshops and attendance.
Credit will only be awarded for completed score cards.
Name
Session
On scale of 1through 5 with 5 being most likely
Scale 1-5
1. Were learning objectives met?
2. Was instruction free of commercial bias?
3. Was there adequate instruction before practice?
4. Was there adequate supervision during practice?
5. Were training aids useful/realistic in learning skill?
6. How likely are you to perform these skills in future
7. Did this training improve your skills?
Comments:

17. Videostroboscopy Workshop: Score Card
Rotate and complete each station.
“Go/No Go” for internal use only.
Completion of workshop is NOT contingent on pass/fail.
Task Go
No Go
Understand indications & contraindications to exam.
Properly explain procedure.
Apply topical anesthetic & decongestant.
Perform supervised videostroboscopy on simulated patient.
Identify normal anatomy.
Demonstrate proper equipment handling technique.
Comments
Proctor Name
Proctor Signature

18. Videostroboscopy: Room Set Up Proctors Screen Projector Speaker
Station 2
Video Tower
Station 1
Video Tower
Station 4
Projector
Speaker
Equipment Table
Equipment Table
Proctors